Plastics competitiveness?

[Phloston]

As much as I'd love to avoid being that typical naive guy who comes along asking / stressing about his competitiveness for plastics, I'd very much appreciate your feedback.

---------

Just took the Step1: only got a 262; a little bummed bc my practice NBMEs were stronger. Listen, I know saying that I "only got" a 262 would cause an umbrageous uproar on the Step1 forum, but I wouldn't be surprised that this particular PRS forum has more 260-280+ posters than hairs on my head.

I'm doing a 6-yr MD/PhD at an Australian medical school.

Do I have any shot at getting an interview at HMS and other good schools? Or are those pretty much reserved for the 270+ folk (most of you reading this)?

Thanks again,

---

Members don't see this ad.

 

[SDplastics]

I think your step score is way beyond enough for the PRS match.
Biggest challenge will be applying as a foreign grad.

 

[Valadi]

I infrequently had interviewers comment on board scores. They're pretty moot when everyone is more or less the same. On paper basically every applicant has the same stats.

I don't think scores get people the interview, but low scores may keep people from getting them. There's several articles out there about what they value most in an applicant.

 

[Phloston]

(I know this is a long response, but I'd really appreciate anyone's feedback)

------


Basically some people on the Step1 forum have made a case that IMGs have a near zero-percent chance of matching into plastics, regardless of board scores, excepting the one IMG who had supposedly matched last year.

I had had the impression that the Step1 just primarily functions to get you the interview, then it's everything else that matters from there.

The overall number of IMG applicants is a mere fraction compared to the number of AMG applicants. In conjunction with the fact that IMGs also don't statistically perform as well on the Steps, it makes sense that the absolute numbers accepted into top programs / specialties would be abysmal. Perhaps the relative numbers of those getting interviews remain somewhat constant.

After all, it's not like there's formalized interview data floating around. We only see matched/unmatched data.

What would be really significant is if strong, well-rounded IMG applicants just purely weren't getting interviews. Do we have data supporting that?

If only one 260+ IMG matched last year into plastics, you've gotta ask: wasn't the absolute number of IMGs in that category very low already? Then you add on top of that the increasing need for research and USA LoRs. There are many confounding reasons why IMGs don't match, and it's more than likely just a numbers game.

I think it's easy to over-generalize and say that IMGs aren't considered for some specialties. I just think the absolute number of adequately qualified IMG applicants for those specialties is low.

------

I just want some feedback from people on this forum. I'd rather face an inconvenient reality than be delusional.

 

[iamahippo]

As a foreign grad, with that score, wouldn't you be pretty competitive for a general surgery spot? Then you can go plastics from there since you're already in the US right? Only 2 extra years. But I'm only a first year in New York, so maybe this logic is flawed because I am naive.

 

[SDplastics]

As a foreign grad, with that score, wouldn't you be pretty competitive for a general surgery spot? Then you can go plastics from there since you're already in the US right? Only 2 extra years. But I'm only a first year in New York, so maybe this logic is flawed because I am naive.

It's 3 years... Plus the further you go ahead, the less independent tracks there will be. This year, it's around even- # of integrated vs. independent spots.

Obviously, if you are stellar all around, then you should apply. Some programs even look at the whole VISA thing (paperwork, etc.) as a hassle. Just means it will be tough, not impossible.
Maybe one of the program directors here can chime in... Moravian, others?

 

[iamahippo]

It's 3 years... Plus the further you go ahead, the less independent tracks there will be. This year, it's around even- # of integrated vs. independent spots.

Obviously, if you are stellar all around, then you should apply. Some programs even look at the whole VISA thing (paperwork, etc.) as a hassle. Just means it will be tough, not impossible.
Maybe one of the program directors here can chime in... Moravian, others?

Ah well I meant 6 years integrated versus 8 years independent (5 years general + 3 years plastics) but I think I see your point. Can you elaborate on what you meant by "the further you go ahead, the less independent tracks there will be"? I'm having trouble understanding that part, thanks.

 

[fizzle]

Where I'd take issue with this logic is that a program's choice in who to invite for interviews is not completely based on quantitative factors. There's a huge subjective component, whether it be who wrote your letters, what regions you have connections to, what kind of research you've done, etc. It could even be something as unrelated as an interesting hobby that you might have that tips you over the scale to getting an interview. Your board score is fine. The IMG issue falls more into the subjective component of whether a program considers you; it's not simply a matter of them generally getting lower board scores on the whole.

(I know this is a long response, but I'd really appreciate anyone's feedback)

------


Basically some people on the Step1 forum have made a case that IMGs have a near zero-percent chance of matching into plastics, regardless of board scores, excepting the one IMG who had supposedly matched last year.

I had had the impression that the Step1 just primarily functions to get you the interview, then it's everything else that matters from there.

The overall number of IMG applicants is a mere fraction compared to the number of AMG applicants. In conjunction with the fact that IMGs also don't statistically perform as well on the Steps, it makes sense that the absolute numbers accepted into top programs / specialties would be abysmal. Perhaps the relative numbers of those getting interviews remain somewhat constant.

After all, it's not like there's formalized interview data floating around. We only see matched/unmatched data.

What would be really significant is if strong, well-rounded IMG applicants just purely weren't getting interviews. Do we have data supporting that?

If only one 260+ IMG matched last year into plastics, you've gotta ask: wasn't the absolute number of IMGs in that category very low already? Then you add on top of that the increasing need for research and USA LoRs. There are many confounding reasons why IMGs don't match, and it's more than likely just a numbers game.

I think it's easy to over-generalize and say that IMGs aren't considered for some specialties. I just think the absolute number of adequately qualified IMG applicants for those specialties is low.

------

I just want some feedback from people on this forum. I'd rather face an inconvenient reality than be delusional.

 

[Moravian]

Maybe one of the program directors here can chime in... Moravian, others?

It is a subjective thing. Dealing with VISA issues is very painful. We took an IMG a few years ago and it was touch and go as to whether or not he was even going to be allowed back into the US after we matched him.

I would say it's certainly not impossible, but any IMG is a long shot. With the number and competitiveness of US grads, you would have to be stellar. My experience is that it more commonly happens after general surgery training, or after being in a lab at a particular program for a few years.

--M

 

[droliver]

As Moravian noted. It's really not worth considering most FMG/IMG applicants, particularly when the US applicant pool is already so competitive. Most of the ones I've seen match have come here and worked in labs or were already trained overseas and came as "fellows" and were worked into a traditional spot.

With the integrated programs eventually set to replace all the traditional programs (the feds have indicated they eventually aren't going to fund 2nd specialty training positions anymore), the pathway for plastics training following other prior residencies in surgery, ortho, or ENT will be gone within a generation.

 

[Phloston]

I went and did the dirty work trying to come up with actual figures:

During the 2009 match, only 359 people worldwide broke 260 on the Step1 out of 26651 test takers (see first image). Assuming comparable 2011 numbers, the fraction of that which comprises IMGs applying into plastics is abysmal.

In 2011, only TWENTY-NINE independent applicants applied into plastic surgery (see second image). The matched mean Step1 was 221; the three matched applicants with <210 Step1s were likely full-blown physicians with lots of previous experience. Independent applicants also refer to DO, non-US citizen IMGs and previous graduates (correct?). The number that is US-citizen IMGs is a mere fraction.

There were ZERO independent applicants for plastic surgery who had scored >260 on Step1.

However, there were three who were between 251-260; only one of those three matched (see third image), and who knows if the other two even had research or US LoRs.

My case is that the number of IMGs who had >260 Step1, strong research and regional LoRs was literally ZERO in the 2011 match. This, NOT some arbitrary bias against IMGs, explains why none matched.

 

[Valadi]

You're welcome and should apply if you are considering it. Bear in mind every year there will be several MD/PhD students with spectacular board scores and letters from the big names in PRS as well. Sans the PhD, there will literally be dozens of applicants with the exact same stats of you. I believe that Moravian and droliver are correct, it really does come down to who writes your letters/will vouch for you, and extraneous criteria that make interviewers think they would like to work with you for 6 years.

That being said, I know of several IMGs who matched into PRS at very prestigious institutions. However, all of them spent time in the lab there beforehand. I mean, even US students will take a year out to spend time in the lab at an institution they're considering.

Again, certainly try if you are set on coming to the States, but there are some fantastic PRS programs in Australia as well.

Going back to your original post, the 260/270 distinction is not an issue.